There is usually no inciting event or precursor to attacks. In general, the frequency of attacks decreases with increasing age. The course is variable: some patients may only experience 1 or 2 episodes in their lifetime, whereas some have many recurrences. Patients may also endorse a history of prior episodes of blurred vision and eye discomfort that may be suggestive of prior attacks these episodes may be months to years apart and last from several hours to weeks. Blurred vision or halos are usually associated with a mild corneal edema caused by elevated IOP. In some cases, the patient may not experience any pain. There are rare cases reported of a bilateral presentation. Patients usually present with unilateral blurred vision and mild eye discomfort or pain. See Possible Etiologies for further discussion. The origin of these mononuclear cells is still unknown.įigure 1: (a) Electron microscopy of trabecular meshwork in a PSS patient (b) higher magnification view. On electron microscopy, mononuclear cells were seen intercalated in the trabecular meshwork with long pseudopods, possibly impeding the outflow of aqueous (see Figure 1). However, one case of a patient with PSS who underwent trabeculectomy for uncontrolled IOP on medical therapy demonstrated presence of mononuclear cells in the trabecular meshwork of an intra-operative specimen. The exact pathophysiology of PSS is still unknown. The only study looking at population statistics came out of Finland, which found an incidence of 0.4 and prevalence of 1.9/100,000.
PSS typically affects adults between the age of 20-50 years, although a case of an affected 13-year-old has been reported.
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